Individual provider Active NPI

Jennifer L. Lavallee, APRN

  • Pediatric Nurse Practitioner
  • Merrimack, NH
National Provider Identifier
1396722153
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0447952302 Issued in NH
Practice address
696 Daniel Webster Hwy
Merrimack, NH 03054-2748
Phone
(603) 429-3155
Fax
(603) 424-8693
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0447952302 NH Primary

Addresses

Primary practice location

696 Daniel Webster Hwy
Merrimack, NH 03054-2748

Mailing address

PO Box 3677
Nashua, NH 03061-3677
Phone (603) 577-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171204000728 NH Practitioner - Nurse Practitioner 9032476809 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0447952302NHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Medical Partners Inc. CurrentSince Dec 4, 2017 Accepting new patients
Foundation Medical Partners Inc CurrentSince Dec 4, 2017 Accepting new patients

Locations

696 Daniel Webster Hwy
Merrimack, NH 03054
Phone (603) 429-3155

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

22 Cotton Rd
Nashua, NH 03063
Phone (603) 899-6147

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1396722153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3677",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030613677",
            "telephone_number": "603-577-7900",
            "fax_number": "603-577-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 DANIEL WEBSTER HWY",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030542748",
            "telephone_number": "603-429-3155",
            "fax_number": "603-424-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLEE",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NH",
            "license": "0447952302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrimack, NH

Sources for this page

Verify at the official NPI Registry.